Farm living and allergic rhinitis from childhood to young adulthood: Prospective results of the GABRIEL study
Authors: Sonja Strieker, Tobias Weinmann, Jessica Gerlich, Erika von Mutius, Dennis Nowak, Katja Radon, Laura Wengenroth
Journal: Journal of Allergy and Clinical Immunology (2022)

BackgroundGrowing up on a farm is associated with a reduced prevalence of respiratory allergies in childhood. Whether this protective effect remains into adulthood is unknown.ObjectivesWe aimed to prospectively investigate the relationship between farm exposure and prevalence of allergic rhinitis and wheeze from childhood to early adulthood.MethodsParticipants from phase 2 of the Multidisciplinary Study to Identify the Genetic and Environmental Causes of Asthma in the European Community (GABRIEL) who were living in southern Germany (aged 6-11 years at baseline and 20-25 years at follow-up) were invited to complete a questionnaire on sociodemographic data, farm contact, respiratory symptoms, and potential confounders. Odds ratios (ORs) with 95% CIs were modeled by using generalized estimating equations.ResultsOf the 2276 phase 2 participants, 1501 (66%) answered the follow-up questionnaire, of whom 1333 could be included in the analyses. Living on a farm was associated with reduced prevalence of allergic rhinitis (OR with persistent farm living = 0.4 [95% CI = 0.2-0.6]; OR with farm living at baseline only = 0.4 [95% CI = 0.2-0.8]). The OR for development of symptoms from baseline to follow-up was almost 3 (OR = 2.7 [95% CI = 2.1-3.3]) irrespective of farm living. For symptoms of wheeze, no statistically significant association with farm living was observed.ConclusionsThe protective effect of farm living on allergic rhinitis persists from childhood to early adulthood. Continuing exposure over puberty does not add to the effect. This confirms that the window of opportunity for a protective effect might be found in childhood. Growing up on a farm is associated with a reduced prevalence of respiratory allergies in childhood. Whether this protective effect remains into adulthood is unknown. We aimed to prospectively investigate the relationship between farm exposure and prevalence of allergic rhinitis and wheeze from childhood to early adulthood. Participants from phase 2 of the Multidisciplinary Study to Identify the Genetic and Environmental Causes of Asthma in the European Community (GABRIEL) who were living in southern Germany (aged 6-11 years at baseline and 20-25 years at follow-up) were invited to complete a questionnaire on sociodemographic data, farm contact, respiratory symptoms, and potential confounders. Odds ratios (ORs) with 95% CIs were modeled by using generalized estimating equations. Of the 2276 phase 2 participants, 1501 (66%) answered the follow-up questionnaire, of whom 1333 could be included in the analyses. Living on a farm was associated with reduced prevalence of allergic rhinitis (OR with persistent farm living = 0.4 [95% CI = 0.2-0.6]; OR with farm living at baseline only = 0.4 [95% CI = 0.2-0.8]). The OR for development of symptoms from baseline to follow-up was almost 3 (OR = 2.7 [95% CI = 2.1-3.3]) irrespective of farm living. For symptoms of wheeze, no statistically significant association with farm living was observed. The protective effect of farm living on allergic rhinitis persists from childhood to early adulthood. Continuing exposure over puberty does not add to the effect. This confirms that the window of opportunity for a protective effect might be found in childhood.